目的 探讨128层螺旋CT肺动脉造影(CTPA)评价急性肺栓塞患者栓塞程度及其与右心功能的相关性以及临床价值.方法 43例急性肺栓塞患者行CTPA检查,根据死亡风险评估将患者分为高危组(18例)和非高危组(25例).在CTPA图像上分析2组CT阻塞指数及右心功能参数的差异及二者间的关系.结果 高危组CT阻塞指数(中位数23.87%)高于非高危组 (中位数9.72%).2组间右心功能参数8项有统计学差异,3项无统计学差异.肺动脉CT阻塞指数与右心功能计量指标间相关性均有统计学差异.CT阻塞指数、右心室短轴最大径(RVMSA)、左心室短轴最大径(LVMSA)、RVMSA/LVMSA(RVLV)、主肺动脉直径及奇静脉直径Az值均＞0.5.结论 CTPA能够较准确地评价急性肺栓塞程度及其与右心功能的相关性,为临床治疗提供重要的信息.%Objective To evaluate the severity of acute pulmonary cmbolism( APE) , its correlation with right heart function and the clinical value by using 128-slicc spiral CT pulmonary angiography (CTPA). Methods 4 3 cases with APE underwent CTPA examinations, according to the risk of death, the patients were divided into two groups: high-risk group ( 18 cases) and non-high-risk group (25 cases). CT obstruction index, right heart function parameters and the correlation between the two groups were analysed comparatively on CT images. Results CT obstruction index in high-risk group (median 23. 87% ) was higher than that in non-high-risk group (median 9. 72%). Right heart functional parameters between the two groups were of significantly differences in 8 items, but no in 3 items. The correlation between CT obstruction indexes and right heart functional parameters was of significant difference statistically. Az values of CT obstruction index, right ventricular maximal short axis( RVMSA) , left ventricular maximal short axis ( LVMSA) , RVMSA/LVMSA ( RV : LV), main pulmonary artery diameter and azygos vein diameter were all higher than 0. 5. Conclusion CTPA can accurately evaluate the obstruction degree of acute pulmonary embolism and its correlation with right heart function,and provide important informations for clinical treatment.
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